How Much Protein Do You Need In Nutritional Ketosis?

The body’s protein metabolism is incredibly dynamic, and limitations in either dietary protein or energy intakes from carbohydrate or fat can tip the balance between gain or loss.

When embarking on a well-formulated ketogenic diet and going through the process of keto-adaptation, there are necessary changes in how the body uses its incoming macronutrients to maintain health and function. To achieve this requires enough protein but not too much.

These tips can help you make your low-carb lifestyle sustainable over the long term.

PROTEIN TURNOVER is going on in every cell, tissue, and organ in the body every day. So in order to maintain your health and function, the body needs to be constantly making new proteins. This requires a consistent supply of amino acids and lots of energy, because making new proteins (aka protein synthesis) is a high-energy process.

The amino acids that the body uses for protein synthesis come from two sources. The most obvious is the dietary protein that we eat each day, but this is normally the lesser contributor of amino acids for protein synthesis. The major source is actually recycled amino acids from the breakdown of existing body protein.

In a typical day when dietary protein and energy intakes are adequate to maintain lean body mass (non-fat mass) more than two-thirds of the amino acids entering the bloodstream come from breakdown of existing body protein, while less than one-third come from digestion and absorption of dietary protein.

Most of the body’s physiological functions are performed by our lean tissue. These functions are dependent upon having adequate amino acids so that they can rebuild themselves on an ongoing basis, and anything that impairs this rebuilding process over just a few weeks or a few months results in measurable losses of lean tissue and of a broad range of functions.

FACTORS AFFECTING PROTEIN BALANCE:  In our dreams, most of us would like to be able to rapidly gain lots of muscle and lose lots of body fat.

But in reality, if each morning we wake up with about the same amount of muscle as we had yesterday, we have been able keep protein synthesis and breakdown about in balance, and that’s a good result.When it comes to changes in our protein metabolism, good things happen slowly.

Factors Known To Stimulate Or Facilitate Lean Tissue Gain:

  • Exercise (particularly resistance exercise)
  • Adequate dietary protein including adequate essential amino acids **
  • Adequate dietary energy (but not necessarily carbohydrate)
  • Increased serum insulin (in the presence of adequate amino acids)
  • Branched chain amino acids.
  • Adequate intra-cellular minerals (e.g., potassium, magnesium, phosphorus)
  • Creatine supplements
  • Illegal use of anabolic steroids and growth hormone

** Essential amino acids are usually only a concern with vegan diets. Learn about food sources in this link https://www.healthline.com/nutrition/essential-amino-acids#bottom-line

Most positive changes in lean body mass occur slowly (an average of a quarter pound per day), whereas losses can occur rapidly with injury, illness, or inadequate dietary protein (including starvation/fasting).  In addition, proteins can only be produced when a number of the factors are working together, including amino acid availability and associated minerals specific to that tissue.

Nutritional ketosis and protein balance:  We have known for many decades that lean body mass and physical well-being can be maintained with a ketogenic diet containing a moderate amount of protein. The 1928 Stefansson Bellevue Experiment demonstrated that 2 adult men could eat about 15% of their dietary energy as protein and maintain their weight and function for a year. These finding were supported by short studies completed by Phinney 1983 and Volek 2004.

In our (Virta) experience, people on a ketogenic diet who think they are eating protein in moderation are often well above the recommended amount due to fear of eating fat to satiety. The result is a reduction in blood ketone levels caused by excess dietary protein. Too low protein consumption does not take allow for recovery from illness, calorie restriction, stress, or aging.

MACROS VS. PERCENTAGES:  An individual’s protein intake during a well-formulated ketogenic diet is pretty much independent of daily energy intake. For example, an otherwise healthy person beginning a ketogenic diet eaten to satiety usually starts out under-eating calories relative to daily energy needs, and thus loses weight.

For example, let’s say that a 5’6” woman starts out at 82 kg (180 lbs) and eats 1300 kcal per day (about a 1000 kcal/day deficit). If her target weight is 132 lbs. (60 kg.), her recommended daily protein intake would be 1.5 X 60 kg Reference Weight ** = 90 g/day, totaling 360 kcal.

** Reference Weight is used for calculations and does not represent total/ lean body weight. It is shown in the link below. Virta recommended we ignore the reference weight and use your height and gender to determine protein intake.

The insert, Daily Consumption of Protein-rich Foods in Ounces, indicates the number of ounces based on 1.5 g/kg of protein.

Daily consumption of protein-rich foods in ounces from kg..jpg

Expressed as a ‘macro’ of what’s on her plate, that’s 24% protein. But 6 months later when she weighed 63 kg (140 lbs) and is eating 2000 kcal per day at weight maintenance, that same protein dose (360 kcal out of 2000) represents a protein ‘macro’ of 16%.

The point is that in this situation where her weight is changing, her daily protein intake should be constant; whereas her ‘macros’ change as she transitions from weight loss to weight maintenance. This changing proportion of dietary protein to dietary energy as one proceeds through weight loss to weight maintenance is shown in Intake and Expenditure diagram below.

Please see the inserted chart:  Intake and Expenditure.

Intake and Expenditure. Changing proportion of dietary protein to dietary energy as one proceeds through weight loss to weight maintenance  copy.jpg

It is better to calculate one’s daily protein need in grams of dietary protein or ‘ounces’ of protein-containing food per day (In this example the ounces is 12 or 11 as in the Daily Consumption Of Protein-Rich Foods In Ounces Chart Above.)

A MODERATE PROTEIN KETOGENIC DIET as part of a well-formulated ketogenic diet allows circulating ketones to reach levels of at least 0.5 mM.  (For more information, click the link below.)

Too much dietary protein can drive down ketone production in the liver. Additionally, when consumed to excess, protein can upset gastro-intestinal function and place a stress on the kidneys to remove the additional nitrogen.

MINERAL CONSIDERATIONS:  Among the many factors that affect the body’s ability to build and maintain its lean body mass, maintaining an adequate balance of essential minerals is very important. Without enough of the potassium and magnesium tissues can’t be built up or even properly maintained. And because inadequate sodium intake causes increased potassium wasting by the kidneys, even salt intake can influence the efficiency with which dietary protein can be used.

In this context, it is also important to understand that our choice of dietary protein and how it is prepared can also influence our essential mineral status.  Four ounces of real chicken, fish, or meat typically contains more than twice the potassium and magnesium found in processed luncheon meats containing the same amount of protein.

CONCLUSIONS:

Achieving and maintaining a protein intake appropriate for a well-formulated ketogenic diet takes practice, and often considerable expert coaching. Individual needs and tolerances may vary, but in almost all cases they are found within the range of indicated in the Daily Consumption Of Protein-Rich Foods In Ounces Chart above. There is no reason to be concerned about long-term consumption of protein in the context of a well-formulated ketogenic diet in someone with normal kidney function.

This is a condensed version of the Virta post. Here is the link to that post https://blog.virtahealth.com/ Next select Science & Research for How Much Protein Do You Need In Nutritional Ketosis? By Stephen Phinney, MD, PhD Jeff Volek, PhD, RD, etc. al. on February 21, 2018

To learn more please read the book the Dr. Phinney co-authored with Dr. Volek.    New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great Paperback – Mar 2 2010

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Author: 2healthyhabits

My goal in life is to experience the exuberance of true good health by returning my body to the healthy state it was meant to have.